Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, Sherbrooke, Quebec, Canada.
École de Réadaptation, Université de Sherbrooke, Sherbrooke, Quebec, Canada.
BMJ Open. 2020 Dec 29;10(12):e040272. doi: 10.1136/bmjopen-2020-040272.
To review all studies having examined the association between patients with physical injuries and frequent emergency department (ED) attendance or return visits.
Systematic review.
Medline, Cumulative Index to Nursing and Allied Health Literature (CINAHL) and PsycINFO databases were searched up to and including July 2019.
English and French language publications reporting on frequent use of ED services (frequent attendance and return visits), evaluating injured patients and using regression analysis.
Two independent reviewers screened the search results, and assessed methodological quality using the Joanna Briggs Institute tool for prevalence studies. Results were collated and summarised using a narrative synthesis. A sensitivity analysis was performed to evaluate the repercussions of removing a study that did not meet the quality criteria.
Of the 2184 studies yielded by this search, 1957 remained after the removal of duplicates. Seventy-eight studies underwent full-text screening leaving nine that met the eligibility criteria and were included in this study: five retrospective cohort studies; two prospective cohort studies; one cross-sectional study; and one case-control study. Different types of injuries were represented, including fractures, trauma and physical injuries related to falls, domestic violence or accidents. Sample sizes ranged from 200 to 1 259 809. Six studies included a geriatric population while three addressed a younger population. Of the four studies evaluating the relationship between injuries and frequent ED use, three reported an association. Additionally, of the five studies in which the dependent variable was return ED visits, three articles identified a positive association with injuries.
Physical injuries appear to be associated with frequent use of ED services (frequent ED attendance as well as return ED visits). Further research into factors including relevant youth-related covariates such as substance abuse and different types of traumas should be undertaken to bridge the gap in understanding this association.
综述所有研究，以评估躯体损伤患者与频繁急诊就诊或复诊之间的相关性。
系统综述。
截至 2019 年 7 月，检索 Medline、Cumulative Index to Nursing and Allied Health Literature（CINAHL）和 PsycINFO 数据库。
使用回归分析，报告频繁使用急诊服务（频繁就诊和复诊）、评估受伤患者的英语和法语语言出版物。
两名独立审查员筛选检索结果，使用 Joanna Briggs 研究所工具评估流行率研究的方法学质量。使用叙述性综合方法整理和总结结果。进行敏感性分析，以评估去除不符合质量标准的研究的影响。
此次搜索产生了 2184 项研究，去除重复项后，仍有 1957 项研究。78 项研究进行了全文筛选，符合纳入标准并纳入本研究的有 9 项：5 项回顾性队列研究、2 项前瞻性队列研究、1 项横断面研究和 1 项病例对照研究。研究中包括不同类型的损伤，包括骨折、创伤和与跌倒、家庭暴力或事故相关的躯体损伤。样本量从 200 到 1259809 不等。6 项研究纳入了老年人群，3 项研究针对年轻人群。在评估损伤与频繁急诊就诊之间关系的 4 项研究中，有 3 项报告存在相关性。此外，在 5 项以急诊复诊为因变量的研究中，有 3 项文章确定了与损伤之间的正相关关系。
躯体损伤似乎与频繁使用急诊服务（频繁急诊就诊和急诊复诊）相关。应进一步研究包括相关青少年相关协变量（如药物滥用和不同类型的创伤）在内的因素，以了解这种关联。
